The Texas Department of Insurance (TDI) today issued final rules to strengthen protections for consumers who seek assistance from federal health benefit exchange navigators. The rules address insufficiencies in federal standards, as required by Senate Bill (SB) 1795.
“These rules will help ensure Texans have confidence that anyone registered as a navigator has passed appropriate background checks and received the training they need to safeguard a consumer’s most sensitive and personal information,” Commissioner of Insurance Julia Rathgeber said.
For individual navigators who provide enrollment assistance in a health benefit exchange, the rules require background checks, training, and proof of identity. Entities that perform or oversee an individual’s performance of enrollment assistance in a health benefit exchange must provide evidence of financial responsibility. Both entities and individuals providing enrollment assistance are required to register with TDI. There is no fee to register. The rules do not apply to licensed insurance agents.
Navigators have until March 1, 2014, to register with TDI and until May 1, 2014, to complete the required 20 hours of preregistration education courses that consist of TDI-certified, Texas-specific training on the following topics:
- Texas-specific Medicaid and Children’s Health Insurance Program provisions (five hours),
- applicable privacy requirements (five hours),
- ethics (five hours),
- basic insurance terminology and how insurance works (two hours),
- exam preparation (two hours), and
- completion of a final examination (one hour)
The rules prohibit navigators while providing navigator services from the following:
- Charging consumers for providing information about health coverage
- Selling, soliciting, or negotiating health insurance coverage
- Recommending a specific health benefit plan, and
- Engaging in electioneering activities, or otherwise supporting the candidacy of an individual for government positions
The final rules apply to both federal grant recipients and other entities and individuals which may wish to provide federal benefit exchange enrollment assistance.
Under the rules, Texas Insurance Code provisions related to privacy and protection of personal information would also apply to navigators.
TDI worked diligently to ensure a deliberate and transparent discussion throughout the rule-making process. An initial stakeholder meeting was conducted to gather comments on how the agency should approach implementation of SB 1795. A formal rule proposal was published in the Texas Register on December 6, 2013, with a 30-day public comment period. Public comment also was heard at two public hearings on the rule proposal. TDI received more than 300 pages of written comments on the rule proposal.
The final rules have been submitted to the Texas Register for publication. To view the final rules, visit: http://www.tdi.texas.gov/rules/2013/documents/navadoptionorder.pdf .
To access registration forms visit: http://www.tdi.texas.gov/forms/form11.html .